Treatment for Testicular Pain

Once any treatable or harmful cause of chronic scrotal content pain has been ruled out, the next step is to offer therapy. Medical therapy for the treatment of chronic scrotal content pain is challenging and typically empirical. Antibiotics can be prescribed initially if an infectious etiology is suspected.

Non-steroidal anti-inflammatory drugs can be offered should there be an inflammatory component of the pain syndrome. However, a recurrence rate of up to 50% has been shown even when these medications are given in combination with antibiotics.

There may be a role for antidepressant and anticonvulsant medications. Two-thirds of patients reported a greater than 50% improvement in their scrotal content pain with nortriptyline and gabapentin. These medications were much more effective in treating idiopathic chronic scrotal content pain than post-vasectomy pain syndrome.

When the chronic scrotal content pain is found in combination with chronic prostatitis or the chronic pelvic pain syndrome, then pelvic floor physical therapy should be offered. Chronic bacterial or inflammatory prostatitis may be detected by evaluating expressed prostatic secretions for white blood cells or bacteria. There may also be a role for acupuncture in the care of such patients